Kids Club September 24 2021
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Email *
I will be attending Kids Club at Hope Valley Church on September 24 2021 5pm-7pm. *
Required
Child's Name *
Date of birth *
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DD
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Gender *
School attending *
Year level *
Child's Name (2nd)
Date of birth
MM
/
DD
/
YYYY
Gender
Clear selection
School attending
Year level
Child's Name (3rd)
Date of birth
MM
/
DD
/
YYYY
Gender
Clear selection
School attending
Year level
Emergency contact name *
Emergency contact number *
Dietary requirements (select all that apply) *
Required
Please specify child's name and dietary needs
Any medical conditions/allergies? *
Please specify medical conditions/allergies
Permission: I understand that if my child(ren) needs medical attention, I/we will be contacted immediately to take whatever steps are necessary for my/our child(ren). *
Required
I will accept that volunteers and staff connected with Church programs will take every care, and cannot be held accountable for personal injury, loss or theft of property affecting my/our child(ren). *
Required
I/we are happy for photographic images and video of my/our child(ren) to be used for promotional purposes of Hope Valley Church. *
Agreement: Please note that if my child's behaviour becomes inappropriate or unmanageable during this event, parents will be contacted for their collection. *
Required
We are looking forward to seeing your child(ren) at Kid's Club September 24 2021. If current restrictions change due to our COVIDsafe plan and we are unable to hold this event we will contact you via email. *
Required
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